Endocrinology

The study of glands and their secretions, called hormones. Hormones are chemical messengers that communicate with nearby cells, organs or distant cells or tissues. Hormones can be proteins or amino acids, ions or steroid molecules. There has been several that have been identified, the most prominent of them that we discuss daily is insulin. Insulin is a key metabolic hormone that helps to regulate glucose metabolism in cells and tissues as well as regulate growth. The latter aspect is paid less attention and that is what we focus on – the simple observation that people walking around with skin tags on their necks (often unsightly, that they consult with cosmetologists or dermatologist who gladly remove them or freeze them with cryosurgery) signify impending diabetes. This is not recognized in most clinics in India and this leads to serious deterioration of the pancreas (which manufactures insulin) and when the pancreas sends distress signals to the rest of the body, there is advancement of ageing. This is considered as the reason why the risk of heart attacks, stroke and cancer is the same in a pre diabetic as in an established diabetic! Many occasions we see patients with a major heart attack or stroke or cancer with such underlying pathophysiology where sometimes the astute physician can make the connection immediately and advise the patient, but often times not. Thyroid gland has come under more scrutiny these days, again due to the incidence of nodules – little do people know that it may be responding to stress from the pancreas! There is the well known association of diabetes and obesity with thyroid dysfunction, and the treatment of low thyroid state with thyroid hormone could eventually cause diabetes! Male and female osteoporosis (weak bones) are often caused by low underlying hormonal states, and a good endocrinologist should study their physiology and make the necessary recommendations, not general physicians as is often the case.